Health Navigator

Working with the NHS, Health Navigator helps predict and prevent avoidable urgent and emergency care, by combining artificial intelligence with proactive health coaching. This helps address the £6bn challenge of patients who frequently present at A&E as a result of not receiving the sort of holistic care (support, social services, referrals to planned care) that could have avoided the need for them to return. In addition to significantly improved patient-reported outcome measures (PROMs), some deployments in NHS environments have shown: a 59% decrease in unplanned admissions; 52% reduction in A&E attendances; and nearly 40% reduction in total hospital costs for their patients (including bed days, NELs, attendances).

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By Health Navigator

Overview

The Health Navigator solution uses artificial intelligence to identify patients at risk of becoming high intensity users, who are then referred to the company’s telephone-based proactive health coaching service. The AI algorithm is trained on data from local populations and information from almost 30,000 patients studied to date in both the UK and Sweden. The algorithm predicts which patients are likely to escalate into high intensity users, and then these patients are screened manually by Health Navigator’s nursing team. If found to be appropriate for the service, these patients are invited to join the proactive health coaching telephone service. This nurse-led service is provided by registered healthcare professionals.

Furthermore, the global scarcity of evidence for digital health interventions led Health Navigator to work with the Nuffield Trust, constructing an NIHR-registered RCT to evaluate the efficacy of its service. To date, the trial has recruited 1,700 patients. Additionally, Health Navigator’s membership of the DigitalHealth.London accelerator, hosted by Health Innovation Network (HIN), has been invaluable in securing introductions to new NHS partners to expand the company’s deployments.

Health Navigator is currently deployed at seven NHS sites across England, from Devon to Yorkshire. Over 2019, the company treated almost 2000 patients as part of its work improving outcomes across the NHS.

Health Navigator is conducting a 3,000 patient randomised control trial (RCT) in collaboration with the Nuffield Trust, which builds upon a previous 12,000 patient RCT, published in the European Journal of Emergency Medicine.

Whilst we were part of the digitalhealth.london accelerator - a collaborative programme supported by London's three AHSNs, we benefited from numerous introductions to key stakeholders in our field of interest, attending many relevant events. We participated in a productive collaboration with Kingston University and also established a collaboration with an MSc student that contributed significantly to the analysis of our randomised controlled trial impact data.

How did the Innovation Exchange help?

A number of key champions across the AHSN Network have introduced Health Navigator to providers and commissioners locally and helped articulate the benefits the solution can bring to local ecosystems. Health Navigator has worked closely with AHSNs, including joining the AHSN Network Innovation Zones at HETT and NHS Expo, along with being introduced to CCG and Trust stakeholders. The company was a member of the DigitalHealth.London accelerator supported by London's three AHSNs.

In addition, Kent Surrey Sussex AHSN’s team are working with the company to identify local NHS need for and interest in this solution, have been supporting the company in developing their value proposition, and Health Navigator co-presented with KSS AHSN’s Managing Director at the Northern Future Forum of nine European countries in 2019.

Impact & Outcomes

Health Navigator first contracted with Vale of York CCG in 2015, with the first deployment site being York Teaching Hospital NHS Foundation Trust. Health Navigator is now deployed in Staffordshire, East Kent, Mid-Essex, and Devon.

Vale of York

Analysis conducted on PROMs in Health Navigator’s Vale of York deployment demonstrated an increase in patient reported quality of life. SF12 is an international standard survey that measures a patient’s self-reported health. Health Navigator measures patients’ responses before and after the health coaching intervention. Mental health increased by 6%, SF12 physical health increased by 9%, and SF12 general health increased by 16%. Furthermore patient activation, i.e. the patient’s ability and confidence to take control of their own healthcare, (measured by the PAM13 survey) increased by 33%.

There were 150 patients on the RCT and a further 600 on service deployment. An entirely trust-led analysis demonstrated:

Statistically significant reduction in patient mortality compared to control, lasting over a year from date of recruitment

Cost savings of up to £24k per patient on intervention per year including reduced hospital costs and QALY

Health Navigator has grown by some 250% in 2019, this has created ten new jobs. The company signed a 1,000 patient contract in Devon, and a new expanded contract of 1,800 patients in Vale of York in 2019.